Mastering Defensible Pricing in the Era of Price Transparency

In an era where data-driven scrutiny and patient-centered decision-making converge, the importance of defensible pricing in healthcare cannot be overstated. By strategically aligning prices with actual costs and market dynamics, providers can weather the storm of price transparency and emerge as leaders in a landscape defined by trust, competitiveness, and financial sustainability.

Mergers + Acquisitions: Is Your Chargemaster Strategy Sound?

Expansion—through mergers, acquisitions, joint ventures and other strategic partnerships—has become an important tool in a hospital’s strategic wheelhouse. As your footprint expands to encompass the entire continuum of care, how do you ensure your chargemaster strategy is sound and consistent?

Exclusion Screening Requirements for Healthcare Entities: Ensuring Compliance and Protecting Your Organization

In the ever-evolving landscape of healthcare regulations, one crucial aspect that healthcare entities must prioritize is exclusion screening.

10 Steps for Failsafe Charge Data Management

Busy revenue cycle teams often overlook the basic steps of charge data management to attend to more urgent priorities. These proven steps covered in this article are pivotal to keeping “charge data management” a key operational priority.

Transcatheter Valvular Procedure Code Set Updates

Over the last decade, one of the most exciting areas of development in healthcare has been the growth of structural heart and interventional cardiology programs—specifically, the advancement of transcatheter valvular procedure techniques. As the ability to treat a larger population using these novel techniques expands, so must our understanding of the nuances involved in navigating the current rules and regulations from both the clinical and revenue cycle perspectives.

Eight Steps to Reveal Incremental Revenue and Reduce Risk Related to “Lesser-of” and “Stop-Loss” Contract Clauses

Restructuring a hospital’s chargemaster in this era of transparent pricing often results in material increases and decreases in line item charges to align with market norms, unit costs, or a hybrid thereof. Learn how your organization can enhance its financial performance in this environment.

2023 E&M Updates Resources

Wondering how the 2023 updates to E&M guidelines affect your team? Look no further. Our experts have developed a set of customized resources to aid professionals as they put the guidelines into practice.

Evaluation and Management 2023 Updates: What You Need to Know

Changes to 2023 E/M coding will impact CDM files, coding, documentation, charge capture processes, and various information systems. This article outlines new revisions to E/M codes for 2023 and addresses several questions we believe professionals will encounter when they learn of the changes.

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems have experienced years of inadequate inflationary update factors, often reduced by factors such as presumed over-coding under the federal inpatient and outpatient prospective payment systems.

How to Comply With (and Exceed) the CMS Hospital Price Transparency Rule Requirements

CMS penalties have dramatically increased since the Price Transparency Rule was released, and providers must take heed before CMS and a legislative gauntlet arrive at their front door.